MEDICARE: MR. MUNASSI KHUSHI MASIH P.T

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT 10598	CA

General Provider Information

NPI Number	:	1316166135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MUNASSI KHUSHI MASIH P.T

Provider Business Mailing Address
First Line	:	6616 SYCAMORE LN
Second Line	:
City	:	PALMDALE
State	:	CA
Zip	:	93551-1915
Country	:	US
Telephone Number	:	661-951-0090
Fax Number	:	661-951-2940

Provider Business Practice Location Address
First Line	:	44444 20TH ST W
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-2714
Country	:	US
Telephone Number	:	661-951-0090
Fax Number	:	661-951-2940

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	07/08/2007

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